Pain management

Dr Frank Thomas, a passionate specialist Pain Management Physician introduces us to the growing field of Pain Management through a series of questions.

Over the past nine years, Brisbane-based Dr Thomas has travelled every month for several days to QPain clinics in Mackay, Rockhampton and the Sunshine Coast. These clinics draw referrals from all over Queensland, including many from other pain management specialists.

Dr Thomas explains: At QPain clinics, we specialise in specific treatments and have built-in expertise to which patients in remote areas can have access through these regional clinics. In the practice, I employ three nurses full-time to support patients - one has been a clinical nurse for six years, the other two are currently undergoing specific training in the field. Previously, I had a wonderful nurse with 25-years’ experience in pain management before she retired.

Could you give us an overview of this specialist field?

The field of pain management in medicine is a huge area and deals with the whole body. Nowadays, the field is a burgeoning one in terms of innovation.

Pain is the most common presentation to general practitioners. A lot of health care emphasis and dollars are directed to dealing with pain and its underlying causes.

The most prevalent population demographic seeking pain management intervention today, is currently the 50 to 70-year age group. There are also some in their 90’s, and yet others just in their 20’s living with chronic pain, too.

Current best practice in pain management clinics is offering an interdisciplinary team to help clients manage their pain. The interdisciplinary methodology looks at the bio-psycho-social aspects to pain. These teams consist of nurses, sociologists, psychologists, psychiatrists, medical specialists and allied health professionals.

The interdisciplinary team method provides both the umbrella approach (the overview) and the one that wraps securely around each individual patient and provides for many associated treatment courses to be explored. Private health clinics that offer these differentiated styles of treatment can bring solid transformation in people’s lives.

What help can Pain Management clinics offer?

Here, on the Sunshine Coast, we have an assortment of professionals from different specializations available. The contemporary emphasis is on an interventionist approach to pain management and, also, rehabilitation. The Sunshine Coast is fortunate to have four fine Pain Management Specialists: Dr Peter Georgius (Noosa area), Dr Paul Frank (Buderim), Dr Frank Thomas and another who is not currently taking on any more patients, as well as the Sunshine Coast Persistent Pain Management Service.

In 2010, the Federal Government allocated $35 million towards Pain Management affording easier access to fantastic care in this field.

What are the contemporary stand-out pain treatments?

The following are new treatments that are proving to be outstanding successes and have the most successful outcomes long term. These are the Implantable Spinal Cord Stimulator and the Radiofrequency (RF) treatment pain.

The RF procedures use high-frequency alternating current (in the AM RF range) to interrupt or alter nociceptive pathways at various sites. They are used as a therapeutic tool in a variety of chronic pain syndromes. Two modalities of RF current are used in interventional pain medicine.

The Implantable Spinal Cord Stimulators are devices implanted under the skin that send low levels of electricity directly into the spinal cord to relieve painelectrical messaging to all pain states. These have been about for some 50 years. Often patients do not like them as they can feel it working away under their skin.

Today’s new cohort of minimally invasive stimulators offer a very different experience. A patient can test-drive these for a week. At QPain, we have found there to be a 13 to 47 per cent reduction in pain by some 50 per cent more than any other combination of medication and therapy forms.

We have found over time that 30 per cent of patients have an 80 per cent reduction in their pain. This is real transformation.

Patients can test-drive injections via day surgery, although some prefer to stay overnight. One can also have a week-long trial injection before making a decision about a permanent implant. Nowadays, with the new forms of stimulators, there is no discomfort and patients forget they have the stimulator on board. It has really transformed the field of pain management.

The radio frequency method is to cut/cauterise/poach/ burn nerves that link into painful joints to break the connection to pain and then allow the nerve to regrow. This treatment can last for three months to three years. It is not a permanent solution, however, but between treatments the patient can usually lead an active busy life. This is usually day surgery but, again, some prefer an overnight hospital stay.

There are many newish trendy treatments like Botox injections. How effective are these type of treatments?

TENS machine comes under the umbrella of physical treatment. It is predominantly counter stimulation to distract your brain from pain. It is difficult to know exactly with the range of TENS machines on the market, what delivery strength you are getting and what one needs for effective treatment. There are so many alternatives out there, we now sell a particular machine brand in our office.

Botox plays a small role in this field and is very expensive. It is a rarely used in my practice but does remain one of the tools to use.

Medicinal cannabis is used in this field and remains perhaps marginally effective.

For someone suffering with prolonged chronic pain, what is the best place to start when looking for treatment?

A referral from your GP is a necessary step only for the patient to access the Medicare rebate. At any time, Pain Management Specialists can be contacted directly, however it is important to remember that the notion of a primary health care team means in the long run you get a lot better holistic care when it includes your GP.

Any further information you would care to share?

Don’t be afraid to ask your GP to see a Pain Management Specialist. It is a patient’s right to access the best expertise and care for specific health experiences. Drugs are certainly not the answer in response to pain management anymore, and the patient deserves to have the best options for their particular needs laid out for them by the caring expert.

Dr Thomas’s background

A Specialist Pain Medicine Physician, Dr Thomas trained in anaesthesia and pain medicine in New Zealand and was the first Anaesthesiologist Registrar to be involved in establishing a Pain Management Department in New Zealand to help people with chronic pain difficulties.

He has since held specialist positions at many hospitals including the Royal Brisbane Hospital and was Director of The Persistent Pain Service at the Princess Alexandra Hospital in Brisbane from 2011 to 2013, Metro South Health Region. For the past nine years, he has worked in private practice at QPain, which he finds greatly rewarding in helping change patients’ lives and seeing them smile again – painfree.

According to Dr Thomas, pain can be very difficult to describe, with people experiencing pain in different ways and for different reasons. If a patient presents to him his assumption is that their pain is real. He says: “An alarming number of people say to me - ‘I’ve been told that the pain is all in my head.’ For some, it can be very difficult to pinpoint pain sites but if someone believes they have chronic pain, then it is always real. Finding someone who believes that the pain is real is validation for all they are going through. As difficult as it is to describe pain, I assume they have that pain and I believe them.”

Pain Service Directory

NOTE: The first port of call is to always consult with your GP.

SUNSHINE COAST PERSISTENT PAIN MANAGEMENT SERVICE (PPMS)

SCPPMS provides support, education and individual and group multidisciplinary therapy for those with persistent pain. The service can be accessed through the Nambour and Sunshine Coast University Hospital campus.

Ph: 07 5470 6758

SPECIALIST PAIN MANAGEMENT CLINICIANS

Dr Peter Georgius Suite 4, Noosa Central

6 Bottlebrush Avenue, Noosa Heads 4567

Ph: 07 5447 2144

Dr Frank Thomas Suite 605/11

Eccles Boulevard, Birtinya 4575

Ph: 07 3391 7111

Dr Paul Frank

62 King Street

Buderim 4556

Ph: 07 5476 9222

MEDICAL CANNABIS

Dr James Connell

Alchemy In Motion

Shop 2, 24 Lanyana Way, Noosa Heads , QLD 4567

Ph: 07 5474 9093 www.Alchemyinmotion.com.au

PAIN MANAGEMENT CENTRES

Noosa Pain Clinic

29 Hooper Cres

Tewantin, QLD, 4565

Ph: 07 5455 5822

The Migraine & Chronic Pain Clinic

153 Cooyar St, Noosa Heads, Qld 4567

Ph: 0400 740 400

Sunshine Coast Pain Relief

31 Mary St

Noosaville, Qld, 4566

Ph: 07 5412 1567

Energetic Wellness – Pain Relief & Energy Healing

Shop 2/141 Cooroy Noosa Rd

Tewantin, Qld, 4565

Ph: 0419 027 171

Meglio Advanced Therapies

Suite 4, Noosa Central, 6 Bottlebrush Ave, Noosa Heads, Qld, 4567

Ph: 07 5447 2144

Advanced Health Pain, Injury & Spinal Clinic

Shop 1/98 Burnett St, Buderim, Qld, 4556

Buderim - Ph: 07 5456 2836

Bokarina – Ph: 07 5213 0800

Nerve Pain Solution

Body Smart Clinic

38 Namba St

Pacific Paradise, Qld, 4564

Ph: 07 5450 5538

Sunshine Coast Radiology

Integrated Pain Management Locations in Bli Bli, Maroochydore, Warana, Nambour, Selangor

Ph: 1300 697 226